Adolescents are at risk for HIV because of sexual and drug behavior initiated during this developmental period. One subgroup of adolescents at particular risk for HIV is those with severe mental illness (SMI). Parents and families play an important role in teenagers' sexual attitudes, behavior and contraceptive use. Parent-child communication about sexual topics and parental supervision are associated with delays in the onset of sexual activity, fewer pregnancies and sexual partners, more responsible sexual behavior, and increased condom use. This project will implement and evaluate interventions, adapted from our current efficacious intervention, for adolescents with severe mental illness who have had a psychiatric hospitalization within the past two years and are currently receiving outpatient mental health treatment. Family-based and adolescent-only interventions will be compared to a standard of care control group and their relative efficacies determined. Both interventions, based on the Social Personal Framework, will have a large focus on skills and attitudes of special relevance for adolescents with SMI. This project will be conducted at three sites (Rhode Island, Atlanta, and Chicago) and will include three group sessions of three hour duration each, with one booster session. The multi-site implementation will bring together investigators, with specific areas of expertise, who have a long history of successful research collaboration. The relative efficacy of the family-based intervention will be established by an increase in the self-report of condom use and a decrease in incident STD rates. Additional goals include improving parent-child sexuality communication and increasing parental monitoring to reduce risk behavior opportunity and to sustain the intervention effects. This study will produce a family-based intervention that will have utility with adolescents with SMI and their parents and is thus capable of impacting the large number of teens in outpatient mental health treatment.